How To Use CPT Code 67999

CPT 67999 describes a procedure performed on the eyelids that does not have a specific code. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 67999?

CPT 67999 is used to report procedures on the eyelids that do not have a specific code. It is utilized when the provider performs a procedure on the eyelids that is not represented by any of the standard and active CPT codes available.

2. Official Description

The official description of CPT code 67999 is not available. However, it is important to note that CPT guidelines instruct that you should not choose a code that merely approximates the service provided. Instead, you should report the service using only the appropriate unlisted procedure code if no specific procedure or service code exists.

3. Procedure

1. The provider performs a procedure on the eyelids that is not represented by any specific CPT code.
2. The procedure may involve various techniques or interventions to address specific eyelid conditions or concerns.
3. The procedure may be performed using surgical instruments, lasers, or other appropriate tools.
4. The provider follows standard medical practices and guidelines to ensure the safety and effectiveness of the procedure.
5. The procedure may require local anesthesia or sedation, depending on the complexity and invasiveness of the intervention.
6. The provider carefully documents the details of the procedure, including the specific techniques used, any complications encountered, and the patient’s response to the treatment.

4. Qualifying circumstances

CPT 67999 can be used when there is no specific code available to accurately describe the procedure performed on the eyelids. It is important to note that this code should only be used when there is no other appropriate code that closely represents the service provided. The provider must ensure that the procedure performed is medically necessary and falls within the scope of their expertise and training.

5. When to use CPT code 67999

CPT code 67999 should be used when there is no specific code available to accurately describe the procedure performed on the eyelids. It is important to follow CPT guidelines and choose the appropriate unlisted procedure code when no specific code exists. However, it is recommended to report a Category III code when available in place of an unlisted procedure code.

6. Documentation requirements

To support a claim for CPT 67999, the provider must ensure proper documentation. This includes a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. The cover letter should also include one or more similar codes and compare the service to those codes to justify the claim amount being billed. Additionally, the operative notes or other relevant documentation should be included to strengthen the claim and avoid a possible denial. Payers will consider claims with unlisted procedure codes on a case-by-case basis and determine payment based on the documentation provided.

7. Billing guidelines

When billing for CPT 67999, it is important to follow the specific guidelines set by payers. Ensure that the procedure performed on the eyelids does not have a specific code available. Include a cover letter explaining the reason for using the unlisted code and provide supporting documentation. It is also recommended to compare the service to similar codes to justify the claim amount being billed. Remember to submit the claim with the appropriate modifiers, if required by the payer.

8. Historical information

CPT 67999 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a specialized eyelid procedure to correct a congenital eyelid malformation.
2. A patient undergoes an eyelid reconstruction procedure following trauma or injury.
3. A provider performs an eyelid biopsy to diagnose a suspicious lesion.
4. A patient receives an eyelid procedure to address excessive eyelid skin causing visual impairment.
5. A provider performs an eyelid revision surgery to correct a previous unsatisfactory eyelid procedure.
6. A patient undergoes an eyelid tumor excision procedure to remove a malignant growth.
7. A provider performs an eyelid ptosis repair procedure to correct drooping eyelids.
8. A patient receives an eyelid procedure to address an ectropion or entropion condition.
9. A provider performs an eyelid reconstruction procedure following the removal of a large eyelid tumor.
10. A patient undergoes an eyelid procedure to address a complex eyelid deformity.